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NIH MedlinePlus the Magazine, Trusted Health Information from the National Institutes of Health

Atrial Fibrillation

Atrial Fibrillation: When the heart is not in rhythm

For more than 30 years, Howie Mandel has been a popular presence on television talk and game shows, comedy clubs, and in movies. As a host, performer, and producer, Mandel keeps a nonstop schedule, performing as many as 200 shows a year. But when his doctor told him he had atrial fibrillation, or AFib, not caused by a heart valve problem, the comedian learned it was no laughing matter. He educated himself about AFib and now helps to educate others about the condition. He lives in Los Angeles with his wife, Terry, and their three children. Mandel recently answered questions about his AFib for NIH MedlinePlus magazine.

Howie Mandel and co-host Theo Von on the set of their TV show, Deal With It.
Photo: TBS/Deal

Understanding Atrial Fibrillation

Atrial fibrillation (AFib) is the most common type of arrhythmia—a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. AFib occurs if rapid, disorganized electrical signals cause the heart's two upper chambers—called the atria—to fibrillate. The term "fibrillate" means to contract fast and irregularly in an uncoordinated manner that does not effectively pump blood through the atria.

In AFib, blood pools in the atria. It isn't pumped completely into the heart's two lower chambers, called the ventricles. As a result, the heart's upper and lower chambers don't work together as they should. People who have AFib may not feel symptoms. However, even when AFib isn't noticed, it can increase the risk of stroke. In some people, AFib can cause chest pain and eventually lead to heart failure, especially if the heart rhythm is very rapid.

AFib may happen rarely or every now and then, or it may become an ongoing or long-term heart problem that lasts for years. AFib may be brief, with symptoms that come and go and end on their own. Or, the condition may be chronic and require treatment. Sometimes AFib is permanent, and medicines or other treatments can't restore a normal heart rhythm.

People who have AFib can live normal, active lives. For some people, treatment can restore normal heart rhythms. For people who have permanent AFib, treatment can help control symptoms and prevent complications. Treatment may include medicines, medical procedures, and lifestyle changes.

What Causes Atrial Fibrillation?

Atrial fibrillation occurs if the heart's electrical signals don't travel through the heart in a normal way. Instead, they become very rapid and disorganized.

Damage to the heart's electrical system causes AFib. The damage most often is the result of other conditions that affect the health of the heart, such as high blood pressure and coronary heart disease.

The risk of AFib increases as you age. Inflammation also is thought to play a role.

Sometimes, the cause of AFib is unknown.

You were diagnosed with AFib. Can you tell us about how that happened?

I found out by chance at a physical that I had to do before starting a new TV show. The doctor put a stethoscope to my chest and said, "Uh oh." That's something you never want to hear. The doctor found out that I had an irregular heartbeat called atrial fibrillation, or AFib, not caused by a heart valve problem.

What were your first thoughts upon getting the diagnosis?

At first I didn't think there was any big deal. Then the doctor explained to me what it was and what it can cause. I panicked. I learned that this could possibly cause a stroke, and I thought I better educate myself. I had no idea that this could make me five times more likely to have a stroke than somebody who doesn't have it.

Looking back, did you have any symptoms before you were diagnosed that you either didn't notice or dismissed?

Looking back, I was not aware of my symptoms. I run seven miles a day, so I thought I pushed it a little hard. If I was a little dizzy or had a little flutter, I just thought that was part of my workout. I didn't really put two and two together.

You lead a very active and busy life. How do you manage your AFib? Did you change any lifestyle habits?

Since my diagnosis, I've continued to have a healthy diet and exercise regularly. I run seven to 10 miles a day. While I've learned about my risks, I haven't let AFib slow me down.

Howie Mandel

Mandel keeps a rapid schedule, from
America's Got Talent and Deal With It
to his almost 200 shows per year.
Photo: TNBS/Americas Got Talent

What is the message you'd most like to send to people who have been diagnosed with AFib or may have its symptoms?

Education is key. For those who have AFib not caused by a heart valve problem, it is important to work with your doctor to discuss treatment options to help reduce the risk of stroke.

I'm excited to be part of the Fibs or Facts campaign, in association with the National Stroke Association, to raise awareness about AFib and its increased risk for stroke. The fact is that education is the best weapon against any health problem that one may have. Let's face it, ignorance is not bliss. Now that I've learned about it, and know what the signs are and can manage it, I feel healthy. And that's what the Fibs or Facts campaign is about—teaching people the facts and educating people to help prevent AFib-related stroke.

You have done just about everything—producing, writing, acting, hosting, judging, stand-up, and much more. What does the future hold for Howie Mandel?

I'm still involved in America's Got Talent and proud that the show was number one in the ratings this past summer. I also serve as executive producer of the TBS series Deal With It, which is a hidden-camera ambush show where unsuspecting members of the public are secretly dared to pull a prank on their unwitting companions with absolutely no time to prepare.

Read More "Atrial Fibrillation" Articles

Atrial Fibrillation / Who Is at Risk for Atrial Fibrillation? / Atrial Fibrillation Complications / Diagnosis / Treatment

Winter 2015 Issue: Volume 9 Number 4 Page 20-21